A doctor whose abortion clinic was described as a filthy, foul-smelling "house of horrors" that was overlooked by regulators for years was charged Wednesday with murder, accused of delivering seven babies alive and then using scissors to kill them.
Dr. Kermit Gosnell was also charged with murder in the death of a woman who suffered an overdose of painkillers while awaiting an abortion.
In a nearly 300-page grand jury report filled with ghastly, stomach-turning detail, prosecutors said Pennsylvania regulators ignored complaints of barbaric conditions at Gosnell's clinic, which catered to poor, immigrant and minority women in the city's impoverished West Philadelphia section.
Prosecutors called the case a "complete regulatory collapse."
"Pennsylvania is not a Third World country," the district attorney's office declared in the report. "There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago."
Gosnell, 69, was arrested and charged with eight counts of murder in all. Nine of Gosnell's employees -- including his wife, a cosmetologist who authorities say performed abortions -- also were charged.
Prosecutors said Gosnell made millions of dollars over three decades performing thousands of dangerous abortions, many of them illegal late-term procedures. His clinic had no trained nurses or medical staff other than Gosnell, a family physician not certified in obstetrics or gynecology, prosecutors said.
At least two women died from the procedures, while scores more suffered perforated bowels, cervixes and uteruses, authorities said.
Under Pennsylvania law, abortions are illegal after 24 weeks of pregnancy, or just under six months, and most doctors won't perform them after 20 weeks because of the risks, prosecutors said.
In a typical late-term abortion, the fetus is dismembered in the uterus and then removed in pieces. That is more common than the procedure opponents call "partial-birth abortion," in which the fetus is partially extracted before being destroyed. Prosecutors said Gosnell instead delivered many of the babies alive.
He "induced labor, forced the live birth of viable babies in the sixth, seventh, eighth month of pregnancy and then killed those babies by cutting into the back of the neck with scissors and severing their spinal cord," District Attorney Seth Williams said.
Gosnell referred to it as "snipping," prosecutors said.
Prosecutors estimated Gosnell ended hundreds of pregnancies by cutting the spinal cords, but they said they couldn't prosecute more cases because he destroyed files.
"These killings became so routine that no one could put an exact number on them," the grand jury report said. "They were considered 'standard procedure.' "
Defense attorney William J. Brennan, who represented Gosnell during the investigation, said: "Obviously, these allegations are very, very serious."
Authorities raided Gosnell's clinic early last year in search of drug violations and stumbled upon "a house of horrors," Williams said. Bags and bottles holding aborted fetuses "were scattered throughout the building," the district attorney said. "There were jars, lining shelves, with severed feet that he kept for no medical purpose."
Few if any of the sedated patients knew their babies had been delivered alive and then killed, prosecutors said. Many were first-time mothers who were told they were 24 weeks pregnant, even if they were much further along, authorities said.
Prosecutors said Gosnell falsified the ultrasound examinations that determine how far along a pregnancy is, teaching his staff to hold the probe in such a way that the fetus would look smaller.
Gosnell sometimes joked about the babies, saying one was so large he could "walk me to the bus stop," according to the report.
State regulators ignored complaints about Gosnell and the 46 lawsuits filed against him, and made just five annual inspections since the clinic opened in 1979, authorities said.